Provider Demographics
NPI:1841283215
Name:NARENDRA M. LODHA, P.C.
Entity type:Organization
Organization Name:NARENDRA M. LODHA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:MAL
Authorized Official - Last Name:LODHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-782-7555
Mailing Address - Street 1:202 UNION AVE
Mailing Address - Street 2:STE A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-7467
Mailing Address - Country:US
Mailing Address - Phone:718-782-7555
Mailing Address - Fax:718-963-0787
Practice Address - Street 1:202 UNION AVE STE A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7467
Practice Address - Country:US
Practice Address - Phone:718-782-7555
Practice Address - Fax:718-963-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00237852Medicaid
NY00237852Medicaid
306571Medicare ID - Type Unspecified